<%-- 
    Document   : cekstatus
    Created on : Dec 29, 2013, 11:25:40 PM
    Author     : Dell
--%>

<%@page contentType="text/html" pageEncoding="UTF-8"%>
<!DOCTYPE html>
<html>
    <head>
         <meta http-equiv="Content-Type" content="text/html; charset=UTF-8">
        <link rel="stylesheet" type="text/css" href="css/kipmol.css">
        <title>KIPEM Online</title>
    </head>
    <body>  <div id="main">
            <div id="header">
               
                <a href="#">
                    <img src="img/Logo_surabaya.gif" id="logo">
                </a>
                <img src="img/kipem.jpg" id="logoText" alt="kipmol">
            </div>
                
            </div>
       <div id="fullpage">
            <div id="welcomeText">
                <p>Silahkan Cek Status Anda</p>
            </div>
             <form id="form1" name="form1" method="post" action="">
  <p>Cek Status : 
    <input type="radio" name="radio" id="pendaftaran" value="pendaftaran" />
  <label for="pendaftaran">Pendaftaran KIPEM</label>
  <input type="radio" name="radio" id="perpanjangan" value="perpanjangan" />
  <label for="perpanjangan">Perpanjangan KIPEM</label>
  </p>
  <p>No ID (KTP / KIPEM) :
    <label for="noID"></label>
    <input type="text" name="noID" id="noID" />
  </p>
  <p>
    <input type="submit" name="submit" id="submit" value="Submit" />
  </p>
  <p>Status	:	
    <input type="text" name="status" id="status" />
  </p>
  <label for="status"></label>
</form>
       </div>   
    </body>
</html>